The Relationship Between Subjective Knee Scores, Isokinetic Testing, and Functional Testing in the ACL-Reconstructed Knee – 1993 Berg Excellence in Research Award paper. Presented at the 15th Annual Sports Physical Therapy Section Team Concept Meeting, Wi

Kevin E. Wilk, William T. Romaniello, Susan M. Soscia, Christopher A. Arrigo, James R. Andrews

1993 Breg Excellence in Research Award paper. Presented at the 15th Annual Sports Physical Therapy Section Team Concept Meeting, Williamsburg, VA, October 15-17, 1993.

It is important to examine the functional relationships between commonly performed clinical tests and to resolve inconsistencies in previous investigative results. The purpose of this study was to determine if a correlation exists between 3 commonly performed clinical tests: isokinetic isolated knee concentric muscular testing, the single-leg hop test, and the subjective knee score in anterior cruciate ligament reconstructed knees. To determine if a relationship exists would be beneficial to clinicians in determining patient progression, treatment modification, and return-to-sport objective parameters. Several investigators have analyzed 2 of these parameters, but no one has investigated 3 parameters to date. Additionally, this study explored the concept of limb acceleration and deceleration during high-speed isokinetics and its relationship to function. Fifty patients were randomly selected (29 males) with a mean age of 23.7 years (range 15-52). The subjects completed a subjective knee score questionnaire that rated symptoms (pain, swelling, giving way) and specific sport function and completed an overall knee score assessment. The patients were then evaluated performing 3 1-legged functional tests: 1) hop for distance, 2) timed hop, and 3) cross-over triple hop. Isokinetic testing was performed on a Biodex dynamometer at 180,300, and 450°/sec for knee extension/flexion. The patients' mean value of the self-assessed knee rating was 86 points. Sixty-four percent of the patients exhibited normal limb symmetry (within 85%) on all 3 single-leg hop tests. Sixteen percent exhibited quadriceps strength at least 90% of the contralateral limb isokinetically. A positive correlation was noted between isokinetic knee extension peak torque (180, 300°/sec) and subjective knee scores, and the 3 hop tests (p<.001). A statistical trend was noted between knee extension acceleration and deceleration range at 180°/sec and 300°/sec for the timed hop test and triple crossover hop (r = 0.48, r = 0.49, r = 0.51, r = 0.49). No positive correlations were found for isokinetic test results for the knee flexors.

J Orthop Sports Phys Ther. 1994;20(2):60-73.

Key Words: knee joint stability, anterior cruciate ligament, muscle strength, functional testing

View Full Article